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Preventive strategies in paediatric cardiovascular surgery: impact on surgical site infections and beyond
Surgical management of congenital heart disease (CHD) has increased worldwide, but healthcare-associated infections (HAIs) can threaten these efforts. To analyse the incidence of HAI, the impact of preventive interventions, and microbiological profiles in a paediatric cardiovascular surgery programm...
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| Published in: | The Journal of hospital infection 2024-08, Vol.150, p.114-124 |
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| container_end_page | 124 |
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| container_title | The Journal of hospital infection |
| container_volume | 150 |
| creator | Montoya, A.M. Roncancio, G.E. Franco, L. López, L. Vargas, A.R. Suárez, S. Garcés, C.G. Guzmán, M. Vanegas, J.M. |
| description | Surgical management of congenital heart disease (CHD) has increased worldwide, but healthcare-associated infections (HAIs) can threaten these efforts.
To analyse the incidence of HAI, the impact of preventive interventions, and microbiological profiles in a paediatric cardiovascular surgery programme.
Cohort study including children aged |
| doi_str_mv | 10.1016/j.jhin.2024.05.001 |
| format | article |
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To analyse the incidence of HAI, the impact of preventive interventions, and microbiological profiles in a paediatric cardiovascular surgery programme.
Cohort study including children aged <12 years with CHD who underwent cardiovascular surgery between 2010 and 2021 in Medellín, Colombia (a middle-income setting). Data were collected from medical and laboratory records and infection control programme databases. Impact of various preventive interventions was assessed using a Poisson model. P < 0.05 was considered statistically significant.
A total of 2512 surgeries were analysed. Incidence of surgical site infection (SSI) was 5.9%, followed by central line-associated bloodstream infection (CLABSI; 4.7%), catheter-associated urinary tract infection (CAUTI; 2.2%), and ventilator-associated pneumonia (VAP; 1.4%). Most of the strategies focused on preventing SSI, resulting in a reduction from 9.5% in 2010 to 3.0% in 2021 (P = 0.030). Antibiotic prophylaxis based on patient weight and continuous infusion had an impact on reducing SSI (RR: 0.56; 95% CI: 0.32–0.99). Vacuum-assisted closure (VAC) in clean wounds reduced 100% of infections. No significant risk reduction was observed for other HAI with the implemented interventions.
Preventive strategies effectively reduced SSI but no other infections, emphasizing the need for targeted approaches to address a broader spectrum of HAI successfully.</description><identifier>ISSN: 0195-6701</identifier><identifier>ISSN: 1532-2939</identifier><identifier>EISSN: 1532-2939</identifier><identifier>DOI: 10.1016/j.jhin.2024.05.001</identifier><identifier>PMID: 38740302</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Antibiotic Prophylaxis - methods ; Cardiovascular surgery ; Cardiovascular Surgical Procedures - adverse effects ; Child ; Child, Preschool ; Cohort Studies ; Colombia - epidemiology ; Congenital heart diseases ; Female ; Healthcare-associated infection ; Healthcare-associated infection prevention ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infection Control - methods ; Male ; Microbiology ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - prevention & control</subject><ispartof>The Journal of hospital infection, 2024-08, Vol.150, p.114-124</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-143a2cf38a0a90ffc3756bd57fb4606f73f356a9ae073a5c57f889d4f45dc063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38740302$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Montoya, A.M.</creatorcontrib><creatorcontrib>Roncancio, G.E.</creatorcontrib><creatorcontrib>Franco, L.</creatorcontrib><creatorcontrib>López, L.</creatorcontrib><creatorcontrib>Vargas, A.R.</creatorcontrib><creatorcontrib>Suárez, S.</creatorcontrib><creatorcontrib>Garcés, C.G.</creatorcontrib><creatorcontrib>Guzmán, M.</creatorcontrib><creatorcontrib>Vanegas, J.M.</creatorcontrib><title>Preventive strategies in paediatric cardiovascular surgery: impact on surgical site infections and beyond</title><title>The Journal of hospital infection</title><addtitle>J Hosp Infect</addtitle><description>Surgical management of congenital heart disease (CHD) has increased worldwide, but healthcare-associated infections (HAIs) can threaten these efforts.
To analyse the incidence of HAI, the impact of preventive interventions, and microbiological profiles in a paediatric cardiovascular surgery programme.
Cohort study including children aged <12 years with CHD who underwent cardiovascular surgery between 2010 and 2021 in Medellín, Colombia (a middle-income setting). Data were collected from medical and laboratory records and infection control programme databases. Impact of various preventive interventions was assessed using a Poisson model. P < 0.05 was considered statistically significant.
A total of 2512 surgeries were analysed. Incidence of surgical site infection (SSI) was 5.9%, followed by central line-associated bloodstream infection (CLABSI; 4.7%), catheter-associated urinary tract infection (CAUTI; 2.2%), and ventilator-associated pneumonia (VAP; 1.4%). Most of the strategies focused on preventing SSI, resulting in a reduction from 9.5% in 2010 to 3.0% in 2021 (P = 0.030). Antibiotic prophylaxis based on patient weight and continuous infusion had an impact on reducing SSI (RR: 0.56; 95% CI: 0.32–0.99). Vacuum-assisted closure (VAC) in clean wounds reduced 100% of infections. No significant risk reduction was observed for other HAI with the implemented interventions.
Preventive strategies effectively reduced SSI but no other infections, emphasizing the need for targeted approaches to address a broader spectrum of HAI successfully.</description><subject>Antibiotic Prophylaxis - methods</subject><subject>Cardiovascular surgery</subject><subject>Cardiovascular Surgical Procedures - adverse effects</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Colombia - epidemiology</subject><subject>Congenital heart diseases</subject><subject>Female</subject><subject>Healthcare-associated infection</subject><subject>Healthcare-associated infection prevention</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infection Control - methods</subject><subject>Male</subject><subject>Microbiology</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - prevention & control</subject><issn>0195-6701</issn><issn>1532-2939</issn><issn>1532-2939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kE2LFDEQhoMo7uzqH_AgOXrpttJJ-kO8yKKrsKCHvYeapLJm6EmPSXpg_r0ZZ_XoqaDqeV-oh7E3AloBon-_a3c_Q2w76FQLugUQz9hGaNk13SSn52wDYtJNP4C4Ytc57wCg7vVLdiXHQYGEbsPCj0RHiiUcieeSsNBjoMxD5AckF7CkYLnF5MJyxGzXGRPPa3qkdPrAw_6AtvAl_lkFizPPoVBNe7IlLDFzjI5v6bRE94q98Dhnev00b9jDl88Pt1-b--93324_3Te2k0NphJLYWS9HBJzAeysH3W-dHvxW9dD7QXqpe5yQYJCobT2M4-SUV9pZ6OUNe3epPaTl10q5mH3IluYZIy1rNhK0GpUQvapod0FtWnJO5M0hhT2mkxFgzobNzpwNm7NhA9pUwzX09ql_3e7J_Yv8VVqBjxeA6pPHQMlkGyjaajNVK8Yt4X_9vwEnbo7C</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Montoya, A.M.</creator><creator>Roncancio, G.E.</creator><creator>Franco, L.</creator><creator>López, L.</creator><creator>Vargas, A.R.</creator><creator>Suárez, S.</creator><creator>Garcés, C.G.</creator><creator>Guzmán, M.</creator><creator>Vanegas, J.M.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202408</creationdate><title>Preventive strategies in paediatric cardiovascular surgery: impact on surgical site infections and beyond</title><author>Montoya, A.M. ; Roncancio, G.E. ; Franco, L. ; López, L. ; Vargas, A.R. ; Suárez, S. ; Garcés, C.G. ; Guzmán, M. ; Vanegas, J.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c237t-143a2cf38a0a90ffc3756bd57fb4606f73f356a9ae073a5c57f889d4f45dc063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Antibiotic Prophylaxis - methods</topic><topic>Cardiovascular surgery</topic><topic>Cardiovascular Surgical Procedures - adverse effects</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Colombia - epidemiology</topic><topic>Congenital heart diseases</topic><topic>Female</topic><topic>Healthcare-associated infection</topic><topic>Healthcare-associated infection prevention</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infection Control - methods</topic><topic>Male</topic><topic>Microbiology</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Surgical Wound Infection - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Montoya, A.M.</creatorcontrib><creatorcontrib>Roncancio, G.E.</creatorcontrib><creatorcontrib>Franco, L.</creatorcontrib><creatorcontrib>López, L.</creatorcontrib><creatorcontrib>Vargas, A.R.</creatorcontrib><creatorcontrib>Suárez, S.</creatorcontrib><creatorcontrib>Garcés, C.G.</creatorcontrib><creatorcontrib>Guzmán, M.</creatorcontrib><creatorcontrib>Vanegas, J.M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of hospital infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Montoya, A.M.</au><au>Roncancio, G.E.</au><au>Franco, L.</au><au>López, L.</au><au>Vargas, A.R.</au><au>Suárez, S.</au><au>Garcés, C.G.</au><au>Guzmán, M.</au><au>Vanegas, J.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preventive strategies in paediatric cardiovascular surgery: impact on surgical site infections and beyond</atitle><jtitle>The Journal of hospital infection</jtitle><addtitle>J Hosp Infect</addtitle><date>2024-08</date><risdate>2024</risdate><volume>150</volume><spage>114</spage><epage>124</epage><pages>114-124</pages><issn>0195-6701</issn><issn>1532-2939</issn><eissn>1532-2939</eissn><abstract>Surgical management of congenital heart disease (CHD) has increased worldwide, but healthcare-associated infections (HAIs) can threaten these efforts.
To analyse the incidence of HAI, the impact of preventive interventions, and microbiological profiles in a paediatric cardiovascular surgery programme.
Cohort study including children aged <12 years with CHD who underwent cardiovascular surgery between 2010 and 2021 in Medellín, Colombia (a middle-income setting). Data were collected from medical and laboratory records and infection control programme databases. Impact of various preventive interventions was assessed using a Poisson model. P < 0.05 was considered statistically significant.
A total of 2512 surgeries were analysed. Incidence of surgical site infection (SSI) was 5.9%, followed by central line-associated bloodstream infection (CLABSI; 4.7%), catheter-associated urinary tract infection (CAUTI; 2.2%), and ventilator-associated pneumonia (VAP; 1.4%). Most of the strategies focused on preventing SSI, resulting in a reduction from 9.5% in 2010 to 3.0% in 2021 (P = 0.030). Antibiotic prophylaxis based on patient weight and continuous infusion had an impact on reducing SSI (RR: 0.56; 95% CI: 0.32–0.99). Vacuum-assisted closure (VAC) in clean wounds reduced 100% of infections. No significant risk reduction was observed for other HAI with the implemented interventions.
Preventive strategies effectively reduced SSI but no other infections, emphasizing the need for targeted approaches to address a broader spectrum of HAI successfully.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38740302</pmid><doi>10.1016/j.jhin.2024.05.001</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antibiotic Prophylaxis - methods Cardiovascular surgery Cardiovascular Surgical Procedures - adverse effects Child Child, Preschool Cohort Studies Colombia - epidemiology Congenital heart diseases Female Healthcare-associated infection Healthcare-associated infection prevention Humans Incidence Infant Infant, Newborn Infection Control - methods Male Microbiology Surgical Wound Infection - epidemiology Surgical Wound Infection - prevention & control |
| title | Preventive strategies in paediatric cardiovascular surgery: impact on surgical site infections and beyond |
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